CytochromeP450 lab/LABCORP/QUEST OF USE??

[Guest guest]

Brother,

I have been loking at some that might be covered by insurance for folks

unable to do Great Smokies.

HERE IS THREE FROM LABCORP AND TWO FROM QUEST....... THOUGHTS?

a.. Cytochrome P450 2C9 Genotyping (511270)

a.. Cytochrome P450 2C19 Genotyping (511320)

a.. Cytochrome P450 2D6 Genotyping (511160)

Sample FROM THESE THREE:

Cytochrome P450 2D6 Genotyping

Number

511160

CPT

83891; 83894; 83908 (x25); 83900; 83901 (x2); 83896 (x25); 83892 (x25);

83903 (x2); 83912

Synonyms

DME Genotyping

Specimen

Whole blood

Volume

7 mL

Minimum Volume

3 mL

Container

Lavender-stopper (EDTA) tube

Storage Instructions

Maintain at room temperature or refrigerate

Cause for Rejection

Hemolyzed specimen; quantity not sufficient

Use

Cytochrome P450 2D6 is involved in the metabolism of up to 25% to 30%

of all clinically used drugs. Mutations in the 2D6 gene can result in ultra

rapid, extensive, intermediate and poor metabolizer phenotypes. Certain

alleles of P450 genes may enhance drug metabolism while others may slow it.

In some cases this may adversely affect treatment outcomes. This should be

considered prior to initiating or modifying treatment or supplementing with

additional drugs.

Limitations

The metabolism of drugs is also influenced by race, ethinicity, diet

and other medications and all factors should be considered prior to

initiating new therapy.

Methodology

Isothermal amplification strategy (Invader Assay)

References

Blue Cross Blue Shield Association Technology Evaluation Center

Assessment Program, Volume 19, No. 9 December 2004; Special Report:

Genotyping for Cytochrome P450 Polymorphisms to Determine Drug-Metabolizer

Status

Copyright © 2003 by Laboratory Corporation of America® Holdings and

Lexi-Comp Inc.

__________**********__________

QUEST ONES VARY ON LOCATION IN USA.

CYTOCHROME P450 2C19 GENOTYPE - (11033X)

. CYTOCHROME P450 2D6 GENOTYPING - (10490N)

ONE SAMPLE BELOW

Performing Lab: Nichols Institute

Clinical Significance: The seven loss of function (null)

allelic variants

analyzed in the test, CYP2D6*3 (A), CYP2D6*4 (,

CYP2D6*5 (D,gene deletion), CYP2D6*6 (T), CYP2D6*7 (E),

CYP2D6*8 (G), CYP2D6*10 (J), and CYP2D6*17, account

for more than 95% of mutations responsible for the

PM phenotype. CYP2D6*1 (wild type), and CYP2D6*2xN

(gene duplication) alleles are also examined in the

test. The mutations are detected by amplification of

the CYP2D6 gene sequences by polymerase chain reaction

(PCR), followed by a single nucleotide primer extension

reaction. The primer extension reaction products are

analyzed on an automated capillary fluorescent DNA

sequencer. DNA-based testing is highly accurate, but

rare false negative/false positive results may occur.

Please contact the laboratory if you have questions

about these test results.

This test is performed pursuant to license agreements

with Roche Molecular Systems, Inc. and Orchid

Biosciences Inc.

This test was developed and its performance

characteristics determined by Quest Diagnostics,

Nichols Institute. It has not been cleared or

approved by the U.S. Food and Drug Administration.

The FDA has determined that such clearance or

approval is not necessary. Performance

characteristics refer to the analytical performance

of the test.

Reference Ranges: Genetic polymorphisms in the

drug-metabolizing genes

are responsible for different metabolic profiles and

thus inter-individual variation in responses to drugs

and chemicals. The CYP2D6 gene encodes for a P450

enzyme, debrisquine hydroxylase, which is responsible

for oxidative metabolism of various therapeutic agents,

including antidepressants, neuroleptics, and

cardiovascular drugs. Allelic variants in the CYP2D6

gene lead to metabolic polymorphisms of these drugs.

5-10% of Caucasian individuals (approximately 2% of

Asians and 2-17% Africans) carry loss of function

alleles that result in the poor metabolizer (PM)

phenotype. The ultra-extensive metabolizer (UEM)

phenotype, resulting from the duplication of the

CYP2D6 gene, is present in up to 7% of Caucasians.

Preferred Specimen: 5 mL whole blood from an EDTA (lavender

top)tube is

preferred.

Whole blood from EDTA (royal blue top) tube,

ACD Solution B (yellow top) tube, Sodium Heparin (green

top) tube is also acceptable.

Bone marrow and Tissue biopsy are also acceptable, but

the Referral Testing department must be called at

410-536-1661, to alert them of the specimen's arrival.

Alternate Specimens:

Minimum Volume: 3 mL

Specimen Container:

Transport Temperature:

Specimen Stability: Room temperature(up to 8 days),

refrigerate(up to

8 days), Do NOT freeze.

Shipping at Room temperature is preferred.

Reject Hemolysis:

Reject Lipemia:

Reject Thaw/Other: Specimens received frozen

Methodology: PCR,SNiPIT Reaction

Setup Days: Set up days at Nichols: Monday, Thursday

Setup Times:

Turnaround: Reports in 5 days

CPT Code(s): PROF

(The CPT codes provided are based on AMA guidelines and are for

informational purposes only. CPT coding is the sole responsibility of the

billing party. Please direct any questions regarding coding to the payer

being billed.)

Test Components: 95748 1 UNT CPT 83891-9L

95756 2 UNITS CPT 83901-9L

95764 2 UNTS CPT83892-9L

95771 1 UNIT CPT 83894-9L

95789 1 UNT CPT 83912-9L

Re: Schaller request/Best CytochromeP450 lab??

> Hi, .

>

> The only reports I've seen on the cytochrome P450s have been from

> Great Smokies. No doubt you are already familiar with what they do,

> but their Genovations Detoxigenomic Profile does report on

> polymorphisms in several of the CYP450 subtypes, and the Great

> Smokies Comprehensive Detox Panel does give a result for caffeine

> metabolism, which unfortunately samples only two of the CYP450

> enzymes, and really, mainly one. Maybe your lab is better. If so,

> it would be interesting to know about it.

>

> Rich

>

>

>>

>>

>> What are the two best CytochromeP450 subtype function labs

> people know about

>>

>> a. Mutations

>>

>> b. Functioning?

>>

>> c. Covered by common insurance?

>>

>> Not sure mine is the best.

>>

>> Best,

>>

>> Schaller, MD

>>

>>

>>

>>